All of you know that I’ve kept a really solid sense of humor since I was first diagnosed with a (benign) Trigeminal Schwannoma. I would not have had 6 previous posts with a title this lame if I didn’t. But I have to tell you that I’m not in the joking mood today.

After hitting this little fucker with a big dose of radiation a year and a half ago I expected this annual MRI to show an unchanged to slightly smaller tumor. That is not the case.

It no longer takes more than 2 seconds for me to show you the tumor on an MRI image.Here it is, looking up from the bottom of my skull:

I’m not a radiologist but I certainly know by now that rule number one or two is to look for asymmetry. Not hard to find when you scroll through the studies. I’m good at that after almost 2 years.

You can’t tell much about the size but, if you look back a year, you can see that it looks about as it did before. If it were as before I would be a happy camper. Unfortunately it is slightly larger and I’m more than slightly disappointed. What I love about my doctor is that she doesn’t try to spin things. When I told her I was bummed she said “yeah, I’m disappointed too”. We were both surprised.

Schwann cells are not very radio-sensitive so this kind of tumor does not generally shrink. But it also does not typically grow. We can’t really tell if the tumor has grown or if this is still just post-radiation inflammation. The latter can actually go on for 2 or 3 years. That is rare but then I’m a special kinda guy. Whatever it is, it’s slightly larger than it was a year ago.

Regardless, since I’ve been transparent about this all along, I just want y’all to know that this is a bummer and I’m having trouble today in keeping my humor up and running.

I’ve often been asked if they can do surgery and just remove it. The answer is that anything is possible but not everything is worth the risk.

First, if they did try to remove it they would almost certainly further damage the nerve. I’d still choose a numb eyeball over a numb face so there’s that.

Second, let me show you a picture I haven’t shared before. Here is an MR Image from the back of my head.

You can see the tumor on the right side of the image, Down below – all that shit that does not look like brain – that’s the base of my skull. The tumor is sitting in a little part of that area called “Meckel’s Cave”. Among other things that’s a bitch to get to. It’s also right where my carotid artery enters. It would sort of suck to accidentally cut through that.

Now… the easy thing to do is to use a Guillotine. The problem is that reassembly is tough (I told you my sense of humor about this sucks – that’s the best fucking joke I can come up with. Sorry.)

Interestingly, even among Neurosurgeons there are lots of sub-specialties. Apparently there are guys called “Skull base specialists” who have… like….. REALLY steady hands. They know how to operate down there. But that sounds about a million times scarier than having a room full of nice people shooting a linear accelerator at you for a few minutes. So, I’d vote “no” without a hell of a reason.

The good news is that Dr. Kubicky also votes “no”. She says that it’s difficult to believe that, with the dose of radiation I had, the tumor has really grown. She still thinks this is inflammation and wants to just keep watching it unless the symptoms change. For the first 2 years watching it was sort of fun. Now, now so much.

So, to summarize my rambling update: Next MRI is in 3 months. Until then, nothing much to do. I’m sure I’ll get over the bit of melancholia. In the meantime the only consolation is that I again have something to worry about other than politics.